title: High BNP level as risk factor for acute kidney injury and predictor of all-cause mortality in STEMI patients.
abstract: OBJECTIVE
  The aim of this study was to evaluate the predictive value of brain natriuretic peptide (BNP) in the development of acute kidney injury (AKI) and 6-month all-cause mortality after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in a modest-risk population.
  
  
  BACKGROUND
  The prognostic value of BNP has been well documented in patients with acute coronary syndrome. However, its value in development of AKI and 6-month all-cause mortality in patients with STEMI undergoing primary PCI remains unclear.
  
  
  METHODS
  We prospectively enrolled 424 consecutive STEMI patients (mean age 53.6 ± 12.1 years) undergoing primary PCI. The population was divided into two groups: a high (n = 110) and a low (n = 314) admission BNP group according to the cut-off value (> 88.7 pg/ml) determined by ROC analysis to have the best predictive accuracy for 6-month all-cause mortality. The clinical characteristics as well as the in-hospital and 6-month outcomes of patients undergoing primary PCI were analyzed.
  
  
  RESULTS
  Cox multivariate analysis showed that a high-admission BNP value (> 88.7 pg/ml) was an independent predictor of AKI development (odds ratio, 1.002; 95 % confidence interval, 1.000–1.003; p = 0.02) and 6-month all-cause mortality (odds ratio, 1.003; 95 % confidence interval; 1.001–1.004; p = 0.004).
  
  
  CONCLUSIONS
  These results suggest that a high-admission BNP level is associated with an increased risk of AKI development and 6-month all-cause mortality in patients with STEMI undergoing primary PCI.
authors.affiliation: Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Kucukcekmece, Istanbul
authors.forename: O
authors.initials: O
authors.lastname: Akgul
authors.forename: H
authors.initials: H
authors.lastname: Uyarel
authors.forename: H
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: N
authors.initials: N
authors.lastname: Isiksacan
authors.forename: S
authors.initials: S
authors.lastname: Turen
authors.forename: M
authors.initials: M
authors.lastname: Erturk
authors.forename: O
authors.initials: O
authors.lastname: Surgit
authors.forename: O
authors.initials: O
authors.lastname: Celik
authors.forename: E
authors.initials: E
authors.lastname: Oner
authors.forename: A
authors.initials: A
authors.lastname: Birant
authors.forename: I F
authors.initials: IF
authors.lastname: Akturk
authors.forename: N
authors.initials: N
authors.lastname: Uslu
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood* / Q000401:mortality*; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D015996:Survival Rate; D014421:Turkey / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain